Behavior Alternatives to Open New Opportunities

Category Archives: Training

“Offering Quality Services” is a large part of our mission. Our senior Applied Behavioral Analysis (ABA) clinical staff provide trainings several times a month for our staff at various levels. These trainings focus on applying ABA techniques to our clients’ specific needs and integrating that work with our comprehensive software systems.

At the same time, Applied Behavioral Analysis is a well-established academic discipline and a professional field with its own certification board (the Behavior Analyst Certification Board). Alternative Behavior Strategies is currently requiring all staff to enroll in board certification programs and is covering the cost of tuition for all clinical ABA employees!

Staff are required to complete the standard RBT (Registered Behavior Technician) process. Additionally, it will be mandatory that they be enrolled in applicable college courses toward further professional certification.

Toward that end, ABS has established a special co-operative program with Florida Institute of Technology through which:

Staff will enroll in coursework

Staff supervision requirements will integrate with work duties — for an intensive practicum experience

Staff will work through the four term sequence in applied behavior analysis at Florida Institute of Technology which is designed to prepare candidates for the national certification examinations sponsored by the Behavior Analyst Certification Board (BACB).

ABS will provide full tuition support for this Florida Institute of Technology coursework for our full time ABA staff and will also cover one-half of the tuition cost for our part time staff.

Once coursework and testing are successfully completed, staff will be eligible for promotion:

Junior Consultant BCaBA (BA level)

Senior Consultant BCBA (MA level)

It is our goal, through the implementation of this training requirement, to improve our practice. We believe that the requirement for higher education will have many positive effects. It will enable us to have a highly trained, long term staff which will

Maximize program benefits for our clients and families

Enhance the stability of staff teams

Encourage consistent ongoing schedules

Enable the professional advancement of our staff within coherent, supportive programs coordinated with our clients’ needs

Decreasing Problem Behavior

When and How to use Punishment Appropriately
by Christa Dalton, BS BCaBA

Punishment is often overused, or used inappropriately without understanding the adverse side effects. Today, I want to show when it is appropriate to use a punishment procedure and ways to implement it that can reduce these adverse side effects.

To use punishment effectively and appropriately we need to first understand what punishment is and isn’t. Punishment is any environmental event immediately following a behavior that decreases the future frequency of that behavior. Punishers include both adding an aversive item/event or removing a pleasurable item/event.

Examples

Every time Timmy bites his nails, he is given a coloring page to complete and the frequency of his nail biting goes down.

When Kayla hits she is immediately placed in a time out chair for 1 minute and the frequency of hitting goes down.

Non-Examples

Every time Joe yells he is reprimanded by his mom saying “No! Stop yelling” and the frequency of his yelling stays the same.

When Jane throws items she is asked to pick the item up and the frequency of her throwing goes up.

Notice that the frequency of Joe and Jane’s inappropriate behaviors stayed the same or went up. This means that the reprimand and being required to pick up items are not punishers for Joe and Jane. They may be aversive events, but they are not punishers. This demonstrates one of the most important things to consider when attempting to decrease problem behaviors. It is critical that we understand why a child is engaging in a particular behavior. Perhaps Jane would throw items when she was asked to sit down and do her homework, and the requirement to pick the item up postponed homework time. Thus picking up the item would actually function as a reinforcer. Once you understand why they are engaging in a problem behavior you can choose a punishment procedure that can actually be effective.

If you choose to implement a punishment procedure you’ll need to be aware of the possible side effects these procedures can have. These could include:

Escape and/or Avoidance: These are behaviors that either end an aversive event (escape) or postpone or prevent an aversive event from happening (avoidance). These behaviors can take many forms and can become more of a problem than the original problem behavior. Examples of these behaviors are; lying, cheating, hiding, truancy, etc.

Counter Aggression: This includes any aggressive behavior (i.e. throwing items, hitting, kicking, hostile comments, videos or comments posted on the internet, etc). These aggressive behaviors often generalize between different environments. A child could be punished in one environment (at school) and have aggressive behaviors in several or all environments (at home, on the bus, on the playground, etc).

Behavioral Contrast: This effect of punishment refers to when punishment is only being delivered in one environment, the behavior will decrease in the punished condition and increase in the unpunished conditioned. For example, before introducing any intervention Sally drew on the wall 5 times a day on average. Dad begins to punish this behavior and her drawing on the wall reduces to once or twice a day in Dad’s presence. Mom doesn’t punish the behavior and Sally draws on the wall 10 times a day in her presence. Now, Sally is drawing on the wall 11 or 12 times a days.

Despite these adverse side effects of punishment, punishment continues to be one of the most common ways a handling problem behavior. Why is this? The answer is simple. People only use punishment when someone is engaging in a behavior that is aversive to them. They want that person to stop engaging in that behavior, otherwise you wouldn’t be punishing it. Typically the immediate (though often not the long term) effect of punishment is they immediately stop engaging in the aversive behavior. This means that your delivery of punishment in reinforcing to your punishing behavior. The aversive behavior was removed. Let’s look at an example, paying attention to mom’s behavior.

The next time Devin starts hitting (or yelling, pinching, throwing things, etc) what is mom likely to do? She will probably take away Devin’s favorite toy. It “worked” before, even if it was only temporary. This means that we need to be careful before using a punishment program. We need to make sure that we have decided to use it because it is the best decision for the child we are working with, not because it’s reinforcing to us.

However, there are times when punishment is appropriate to use (when someone’s behavior is more dangerous to themselves or others than the possible side effects of punishment would be or when other positive procedures have been ruled out as ineffective, are some examples when punishment should be considered). When we decide that a punishment procedure is appropriate, there are ways to lessen the undesirable effects. These include combining punishment with other reinforcing procedures.

Any behavior that occurs more than once is being reinforced in some way (if it wasn’t reinforced there would be no reason to engage in the behavior a second time). This means that when you add a punishment program you need to recognize that you will be competing against a reinforcer. Any time you use a punishment procedure, it it critical that you combine it with other procedures that focus on changing the way your child can access that reinforcer, or reduces the motivation to access that reinforcer. Some of the procedures that can be used in combination with punishment are:

Extinction: withholding the reinforcement of a previously reinforced behavior. Remember how we talked about how critical it is to understand what is maintaining problem behavior? Jane get’s out of doing homework when she has to pick up thrown items. It’s possible to make the behavior of throwing items lose all value by using an extinction procedure. No matter how many items Jane throws, she cannot get up from the table until she has finished her homework. By combining this with a punishment procedure, it’s possible to make throwing items aversive to Jane. Now, when Jane throws an item, not only is she not allowed to get out of homework, but she is also given an extra problem to complete for every item she throws.

Differential Reinforcement: putting one behavior on extinction, while simultaneously reinforcing a different behavior. Let’s continue using the example of Jane, one way that we could use differential reinforcement would be to allow Jane a 2 minute break away from her homework every time she requests a break, but continue to require her to complete her homework even when she throws items. Thus, throwing items is under extinction while requests for a break are simultaneously being reinforced.

Non-contingent Reinforcement: presenting a known reinforcer on a consistent timed basis (every 5 minutes, or every hour, etc) regardless of the chid’s behavior. For an example, John’s screaming behavior has been maintained by attention he receives from parents and caregivers. To use non-contingent reinforcement, John’s parents and caregivers would start giving John attention every 15 minutes, regardless of what he was doing during that time. This attention would reduce John’s motivation to scream for attention because he is being satiated with attention.

In conclusion, there are several ways to use punishment appropriately and effectively. However, it is critical to understand how to use punishment and what to expect when using punishment. If you feel that a punishment procedure would be beneficial for your child, please talk with your consultant. They can help determine what punishment procedures are likely to be effective, as well as provide other options to help your child progress.

What is Music Therapy?

“Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.” (musictherapy.org, “What is Music Therapy”)

Music Therapists must complete a bachelor’s degree in Music Therapy, which includes courses in psychology, human development, anatomy, special education, and core music classes. After coursework and music proficiency tests have been completed at the university level, they must complete a 6 month internship (1200 hours of clinical work), and pass a board certification exam.

Music Therapists work in a variety of settings including hospitals, mental health centers, geriatric facilities, hospice, special needs, etc. A music therapist conducts an assessment and develops a treatment plan that includes goals and objectives. Data is taken throughout the course of treatment that provides for ongoing assessment. Target goal areas may include communication, social skills, cognition, emotional regulation, behavior modification, and motor skills. Music is often performed live (usually on guitar, piano, or other accompanying instrument) in order to meet the needs of the client in the moment. Singing, improvisation, movement to music, instrument playing experiences, and songwriting are some of the techniques that are employed to meet these goals.

About the Author

My name is Lindsey Green. I am a board certified music therapist (MT-BC). I received my degree from Utah State University and completed my music therapy internship at Hartvigsen School in Salt Lake City, Utah in 2013. I love working with individuals with special needs and seeing the growth and development they achieve!

I have worked as a Behavior Interventionist for Alternative Behavior Strategies since February 2014. My job is to go into homes (usually for two to three hours at a time) and implement the ABA programming that has been created by Board Certified Behavior Analysts (BCBA). They have already conducted assessments and determined what programming is best suited to meet the needs of the individual child.

I am careful not to term what I do with music in ABA sessions “music therapy” because I did not create a music therapy treatment plan for them. However, as I implement the BCBA’s programming, I often incorporate music and music therapy techniques to enhance the sessions for the child.

How I use Music in ABA Sessions

Music is a powerful tool because it occurs in the moment, is often predictable, and stimulates numerous areas of the brain as it is being processed. Music experiences generally address various domains of development simultaneously. I will attempt to categorize them and focus on only a few. I use music in sessions to work on cognitive skills, social skills, and to maintain attention.

Cognitive Skills

This has especially proved helpful in teaching phone numbers or addresses. One of the kids I worked with had a program to learn his address. By putting it to a song, he was able to remember it within a day. In this case, I just made up my own short song and sang it with him a few times. I included the discriminative stimulus that was written into his program in the song so that he would generalize better when I did move to a verbal cue (versus the sung cue).

Instruments, such as the guitar or harmonica, are fun to bring in to the sessions occasionally. They provide a sense of novelty to the child that facilitates social interactions with me as the facilitator. Instruments can also provide sensory exploration. One of my younger clients likes to feel the strings of the guitar, either by strumming them or just running his fingers along them. Sometimes I will put his feet on the body of the guitar so he can feel the vibrations through it. These are all ways of facilitating social interactions. In another session, the child was playing by himself and not engaging with me. I started singing (improvising) about what he was doing as he played. He then started doing other things to see if I would also sing about those, thus creating a social interaction game.

Movement to music provides a great way for kids to have a break from more formal ABA work while still working on social awareness and listening skills. In my experience, the funnier the song, the more engagement you’ll get from the child. If you have a group of children, turn-taking with instruments can also be incorporated.

Some movement songs require the child to use their imagination, while others involve following a leader that comes up with original motor movements (another opportunity for turn-taking). This requires the child to watch a peer and imitate them.

Most often, I incorporate movement songs in “mock circle time” with parents, siblings, and peers that might be visiting. During this time, I am charting on goals such as hand raising to answer questions and sitting quietly/ attending to the teacher. In these mock circle times, I choose to incorporate a hello song, a story (with questions about the content), and then sing favorite songs while I play the guitar, take turns with instruments/ imitating peers, or do movement to music.

See the resources section below for some of my favorite movement songs.

Maintaining Attention

Elements of the music can be modified in the moment to elicit different responses from the child. Maybe they are tuning out temporarily. At that time, a music therapist might change an element of the music (volume, speed, style, key, etc.) in order to cue the child that there is something changing. The child might then “wake up” from his tuning out moment and reengage in the experience.

The skill of improvising musically/ vocally often comes in handy. When working one-on-one with a child, a music therapist would base the speed and style of the song upon what the child is doing at that time. For instance, if the child has a lot of energy, the tempo of the song might be faster; if the child is in more of a lounging mood, the speed might start slower.

Conclusion

I have been impressed by the progress that can be achieved as these children are involved with ABA therapy. The style of teaching and methods employed by the staff at Alternative Behavior Strategies can positively influence the child’s rate of learning. In my experience, music added to the structure of ABA programming enhances the learning experience for the child. I hope you will be able to incorporate some of the techniques mentioned in this article.

Alternative Behavior Strategies (ABS) has an extensive, ongoing program of training for their staff. I recently talked with Joe Dixon (Clinical Director at ABS) about staff training. Joe and Jeff Skibitsky (Executive Clinical Director at ABS) meet weekly with all of our consultants and lead behavior interventionists and one of the aspects of these meetings is to assess training needs and the effectiveness of current training materials and programs. From these assessments Joe develops training sessions: twice monthly for Consultants and Lead Behavior Interventionists and once a month for all Behavior Interventionists.

All of this training centers around Applied Behavior Analysis (ABA), a well-developed discipline among the helping professions, with a mature body of scientific knowledge, established standards for evidence-based practice, distinct methods of service, recognized experience and educational requirements for practice, and identified sources of requisite education in universities.

Recently, the Behavior Analyst Certification Board (BACB) has established a certification process for Registered Behavior Technicians (RBT), the role which our Behavior Interventionists currently fulfill at ABS. We are currently working to develop testing materials for this BACB certification process at Alternative Behavior Strategies and we intend for all ABS Interventionists to become Registered Behavior Technicians.

As the Board explains,

The RBT credential will complement the BCBA and BCaBA credentials as an entry-level program that reflects the education and training necessary for the duties of a behavior technician. The RBT is a paraprofessional who practices under the close, ongoing supervision of a BCBA or BCaBA (“designated RBT supervisor”). The RBT is primarily responsible for the direct implementation of skill-acquisition and behavior-reduction plans developed by the supervisor. The RBT may also collect data and conduct certain types of assessments (e.g., stimulus preference assessments). The RBT does not design intervention or assessment plans. It is the responsibility of the designated RBT supervisor to determine which tasks an RBT may perform as a function of his or her training, experience, and competence. The designated RBT supervisor is ultimately responsible for the work performed by the RBT.